We have opted in this report to present the breadth of responses from the IEHPs we interviewed. We intend to supplement this with more in-depth analyses of particularly interesting themes which emerged from our comparative analysis. Some of the analysis that we will be pursing include the following:

What are the gendered dimensions of the experiences of IEHPs?

Although it is hard to come to a definite conclusion from our sample, it seems that the process of integration needs to be understood as a gendered process. Female IMGs often decide to give up during the process and find alternative fields for employment (as midwives, nurses, or practitioners in the field of alternative medicine) due to the uncertainty of the process. Those few women who succeeded in getting into practice reported that this process put a strain on their personal relationships. Some lived apart from their families or partners and felt that the effort that they put into becoming licensed negatively impacted their personal life. This theme was not apparent in the interviews with male IMGs who were practicing.

Although IMGs are less likely to be integrated into the system, the gender composition of nursing and midwifery highlighted the specific difficulties for IEHPs practicing those professions, too. Many IENs and ITMs had to juggle their family responsibilities with pursing professional integration. Taking care of their families meant that they often had difficulties in attending full-time bridging programs. If they were primary applicants, they also had to take the leading roles in integrating their families in Canada. If they were travelling to Canada as dependants, their mobility was restricted to their husband's place of work. Those who were pregnant, or became pregnant during the process, found a challenging situation even more difficult. Thus, by analyzing the process of professional integration as a gendered process and comparing the experiences of IMGs (mixed-gender profession) with the experiences of IENs and ITMs (predominately women's profession) we plan to see how gender intersects with the process of professional integration.

How does the integration process for IEHPs represent a kind of professional resocialization?

While the sociological literature provides a rich understanding about the professional socialization process experienced by medical and nursing students, it rarely deals with the process of re-socialization experienced by professionals who move from one workspace to another. Neither has it paid attention to the process of re-socialization which immigrants have to undergo to adapt to a new professional culture in their host country. By drawing upon the experiences of the IMGs, IENs and ITMs in our study, we intend to demonstrate how the differences in professional cultures can be a major barrier for professional integration, and how this is addressed to a greater or lesser extent in the context of bridging programs and other integration initiatives which aim to facilitate the process of integration of IEHPs into the local workforce. We hope to reveal how current educational settings designed for integration of IEHPs may not be paying sufficient attention to the process of professional re-socialization.

How do the work experiences of fully integrated IEHPs differ by professional category?

Despite significant differences in the countries of origins of newcomer professionals, they experience remarkably similar process of struggling to get into the local system upon their arrival. They also often feel alienated from other members of their profession when integrated and report discrimination at their new workplace. We intend to compare the experiences of the culturally diverse groups of IMGs and IENs we interviewed, and examine in particular, how their differences in professional status shape their experiences of workplace discrimination. Specifically, we plan to explore how the instances of discrimination and racism to which IEHPs are exposed at their workplace differ among physicians and nurses and how the status of the profession can serve as a shield of protection from the experiences of racism and discrimination.

How does the experience of IMGs in particular reflect a professional diaspora?

We intend to apply the concept of diaspora to the analysis of the creation and maintenance of an ethnically diverse community of IMGs, by drawing upon those we interviewed in this study. Traditionally, the research on diaspora concerns ethnic communities that preserve their homeland ties while residing in foreign countries. We suggest, however, that ethnic roots are not imperative for the analysis of diasporic communities when other forms of shared values and meanings can become a basis for creation of collective identity. Reconfiguring both the homeland and host country as places of geographic and professional belonging provides opportunity to conceptualize an ethnically diverse group of immigrant physicians residing in Canada as professional diaspora. Though examining the interviews with the IMGs in our study, we hope to demonstrate (1) how they create medical diaspora, (2) what myths and sensitivities they share in constructing their professional and geographic homelands, and (3) the relationship they develop with their hosting society. We suggest that in spite of the increasing mobility of internationally-educated health care providers, the analysis of professional diasporas could become a useful tool for analyzing complex relationships between home countries, hosting countries, and international travelers.

In closing, we hope these analyses highlight the complexities of the process of professional integration which is linked to immigration and shaped by gender, ethnicity, country of origin, the status of profession and globalization of health care market. We are grateful to our respondents for sharing their personal experiences with us and we hope that future research will allow for a better, simpler and more welcoming process of professional integration. It is important to convey the overwhelming message we came away from our interviews with: IEHPs wish to be productive members of Canadian society and to bring their skills and knowledge to their new home. Knowing about the perceived shortages in health care creates a great deal of confusion to these professionals when they face insurmountable barriers to obtaining a license to practice and respond to the health care needs of the Canadian population.